George Paskalev, 22, moved to Chicago from Bulgaria three weeks ago to go to school at Columbia College. During his first three weeks at his program he is already overwhelmed with homework and assignments. Every year hundreds of students all over the world come to Chicago for better education.

The aging of the Baby Boomer generation is upon us.

That means more and more old Americans are seeking health care coverage through programs like Medicaid. Many states, including Illinois, are worried about how to handle the situation with more patients and less money.

Medicaid is the nation’s largest health insurer providing health care for 60 million Americans. It functions as a partnership between states and the federal government. Right now Medicaid surpasses even Medicare, the second largest federally funded program, in terms of enrollment and spending. In Illinois Medicaid covers 2.6 million people spending $12 billion per year in state and federal funds. 20 % of the enrollees are blind, disabled or elderly and cost Medicaid $700 million per year or $18,000 per patient. Medicaid is designed primarily to help those who are indigent or with very limited means. The elderly have Medicare to pay for most of their physician and hospitalization needs, but Medicare does not pay for nursing home care excerpt for a few weeks immediately following a hospital stay. For limited-income seniors who require nursing home care, Medicaid is often the only potential source of payment.

Illinois’ state budget cannot be ignored when understanding Medicaid. The state and federal governments split payments to hospitals, clinics, doctors’ offices, nursing homes, supportive living facilities, health centers and pharmacies. For the 2008 fiscal year, $13.9 billion was sent by Medicaid to health care providers. Medicaid also covers 50 percent of the state’s births, 25 percent of its nursing home care and 16 percent of hospital admissions.

According to Heather O’Donnell, policy Director for Healthcare and Human Services at the Center for Tax and Budget Accountability in Illinois, “Medicaid, including the State Children’s Health Insurance Program (SCHIP), is the bedrock of the nation’s health care safety-net.”

Between 1999 and 2008 the cumulative growth in average premiums for private family health insurance coverage was 119 percent. “With that increase the state ended up with more people who cannot afford private insurance, which led to more people who need coverage from Medicaid,” O’Donnell said. The Illinois budget deficit for Fiscal 2011 is estimated to exceed $12 billion due to structural imbalances in the state’s revenue system. Furthermore, Illinois’ unemployment rate had increased to 11 percent by Dec. 2009, up from 6.8 percent in Oct. 2008, which put even more people in the Medicaid line.

O’Donnell said there is another significant concern – that the  budget deficiency will seriously affect the quality of health care. “In essence, Medicaid reimbursement to providers becomes, in part the earnings of doctors, nurses, technicians, pharmacists and other staff, as well as local business throughout the medical industry,” she said.

On March 10, 2010, Gov. Pat Quinn unveiled his 2011 fiscal year budget. In his address to the Illinois General Assembly he said: “Services such as home care for older adults, child care and community mental health services will be reduced by $ 276 million. Scaling back prescription drug assistance and group health coverage for state retirees, combined with a managed care pilot program for seniors and adults with disabilities who are enrolled in Medicaid will save the state $ 325 million.”

Another important fact is the correlation between state and federal funding.  “When the state of Illinois, forced by its budget deficits to cut funding of Medicaid, the matching federal funding decreases too. If Illinois cuts $10 million, it will lose an estimated $16.2 million in federal matching funds, resulting in a net cut to Illinois’ Medicaid program of approximately $26.2 million,” O’Donnell estimates. As a result the state will suffer will lose an estimated $80.4 million in lost business activity and $27.6 million in lost wages across the state.

Research conducted in 2010 by the American Medical Association shows that “the number of Americans ages 50 to 64 will grow from 55 million in 2007 to 63 million by 2015 -about an average of 1 million per year. These 50 and 60-somethings will make up about 20 percent of the population.”  AMA also predicts that most baby boomers will have at least one or more chronic health problems. Overall, aging of baby boomers will lead to the need of billions of dollars to the American health care system.

Stacey Solano, spokesperson of Illinois Department of Healthcare and Family shared that, although the majority of the aging baby-boomers will be covered under Medicare, there will be additional pressure placed on Medicaid.  Illinois has implemented several cost-saving programs such as its Disease Management program, Your Healthcare Plus, and its Primary Care Case Management program, Illinois Health Connect.  “The focus of these programs is to promote and sustain patient-physician relationships, to support and educate participants on the appropriate management of their medical conditions, to improve the person’s quality of care/ life, while achieving cost savings to the state by keeping people healthier through better care coordination and preventing unnecessary hospitalizations and emergency room visits.” Solano said.

“In terms of economics, Boomers have been the most important generation since the Founding Fathers,” said Dr. Leslie Harris, Managing Partner of consultancy Mature Marketing and Research. “They now account for over a third of US economic activity and everything they have done since their birth has radically altered the economic and marketing landscapes. It will be no different as they become what used to be called “senior citizens.”

Aaron D”Costa, Vice President of Pathway Senior Living, sees the next fiscal crisis in the aging of baby boomers. “Unfortunately, unlike their parents, Baby Boomers have not saved enough for their own retirement. It will be the next fiscal crisis as their needs for housing and care increase. Thankfully, affordable senior housing operators like us will benefit, but we’re dealing with a tough financial climate right now, and banks are not willing to lend just yet so our aggressive growth strategy has been on hold for the past two years,” D”Costa said.

There are two primary issues concerning the Medicaid program: reimbursement levels and state payment delays.

In Illinois, the state pays a Chicago area nursing home on average $110 per day to care for each Medicaid resident. For the average nursing home operator, however, the cost to deliver the appropriate care is $130 per day, so it is clearly a loss. Operators therefore have a mix of residents – some on Medicaid, some who pay privately, some who are using their Medicare benefits, and some on managed care plans – and through that mix, are able to offset the losses on Medicaid residents. This isn’t the fairest solution – in essence, some residents are paying more than their share in order to cover the costs of Medicaid residents.

The supportive living program in Illinois is reimbursed at roughly $75 per day for Medicaid residents. While the revenues are less than what a nursing home operator would receive, the cost structure for a supportive living environment is much less, and the amount of care that is provided is more limited to help keep costs down. Therefore, a resident who doesn’t need much care and is on Medicaid in a nursing home can move to a supportive living community such as the ones operated by Pathway and can have a better quality of life in nicer, newer surroundings and at the same time, the state benefits by saving nearly $35 per day.

The biggest problem is that Illinois has severely underfunded its liabilities and cannot afford to pay all of its obligations. At the end of 2008 the state’s unpaid Medicaid bills totaled $2.1 billion. As a result, Illinois often delays making its obligated payments, including monthly Medicaid payments to skilled nursing and supportive living operators. Aaron D’Costa said that at Pathway, 80 percent of their revenues come from Medicaid.  And they received a state payment in Feb. for the months of Sept. thru Dec. “We have not received payment since and are now into the fifth month of the year. Imagine a store that has 80 percent of its purchases made by credit card, and that MasterCard and Visa failed to pay the store for five consecutive months. That store would be out of business. It wouldn’t be able to pay its mortgage, the salaries of its employees, the vendors it used to stock its shelves, etc.” he said.

On the other hand, Illinois Department of healthcare says that the state has been consistent in paying its medical practitioners, hospitals and nursing homes within 30 days as required by federal economic stimulus bill, American Recovery and Reinvestment Act (ARRA).  According to Stacey Solano “many other Medicaid providers have been experiencing payment delays related to cash flow issues within the state’s General Revenue Fund.” Furthermore, as part of his fiscal year 2011 introduced budget, the Governor assumed the continuation of ARRA funding beyond its 12-31-10 scheduled expiration and proposed increasing the Illinois income tax to improve the state’s revenue picture. “Absent an ARRA extension and the passage of the Governor’s income tax proposal, or similar increase in state revenues, the Department of Healthcare and Family Services expects provider payment cycle delays to continue, if not increase, in fiscal year 2011,” Solano said.

The new health care plan significantly expands the Medicaid program through the Community Living Assistance Services and Support (CLASS) Act, which is a national long-term care insurance program.  While this program won’t be fully implemented until 2014, states such as Illinois already have a nearly bankrupt Medicaid system, and expanding the program without demonstrating how it is to be paid for, makes supportive living companies extremely worried about the long-term viability of the program.

In terms of the new health care plan, Mr. D’Costa raises some serious concerns, “While there is much speculation about the impact of the new health care plan, there is far too little information readily available on its impact and how and when it will be funded. “

With the stimulus package federal funding on Medicaid was increased from 50 percent to 61.88 percent for the period Oct. 2008 – Dec. 2010. This increase of coverage from federal funds has absolutely helped states strengthen local economies, but at the same time the state of Illinois is still concerned about its budget deficiency.

Facts about the CLASS Act

The Community Living Assistance Services and Supports program (CLASS Act) will be effective on January 1, 2011.  The CLASS benefits will be defined by October 2012 with enrollment to begin subsequently.  However, the payout of CLASS benefits will not take effect until 2017.

• CLASS will work in conjunction with other long-term services and support programs such as Medicaid.
• Eligibility for CLASS program benefits will have no effect on eligibility for Medicaid, Medicare, Social Security retirement, survivors, or disability benefits or Supplemental Security Income (SSI) benefits.
• If an individual is eligible for both CLASS program benefits and long-term services and supports under Medicaid, CLASS benefits will be used to offset the costs of Medicaid.
• Working people (part-time and full-time) and people who’ve already retired but continue to work part-time will be eligible to enroll. Nonworking spouses and unemployed are not eligible for enrollment.
• Participants have to pay premiums for five years, the so-called vesting period, before they can receive benefits, and they have to continue working for three of those five.
• The self-employed and anyone whose employer declines to offer Class coverage — it’s optional— will be able sign up through a yet-to-be-determined mechanism.
• The CLASS program is not designed to replace the need for basic health insurance or for long-term care coverage through Medicaid or private long-term care insurance.  Rather, it will supplement this coverage by providing a mechanism to pay for non-medical expenses that allow a person with a disability to remain independent.
• Individuals who are low-income, or become low income as a result of their medical expenses or other factors, will still qualify for Medicaid long-term services and supports.
• Healthcare reform as it relates to Medicaid primarily affects people under the age of 65.  Since most of the population served by  Supportive Living Facilities is over 65 years old, given what we know today, the Supportive Living program should not be impacted.
• In addition to the CLASS Act, Illinois Healthcare department recently issued a Request for Proposal (RFP) under which two managed care organizations will be selected to provide the full spectrum of Medicaid covered services to older adults and adults with disabilities, who are not eligible for Medicare, residing in Cook collar counties and suburban Cook County under an integrated care delivery system.   This pilot program will affect approximately 40,000 individuals in the selected counties.  Once the effectiveness of the program is evaluated, the department will determine whether it should be employed in other parts of the state. 

Smoke Signals

How do Native American tribes preserve their culture in contemporary America

The 19th Annual Winter Pow Wow took place in Wisconsin State Fair Park, WI on March 6th and 7th and was organized by Indian Summer Festival Incorporated. “We are so spread out and that’s why we have Indian summer, a place where we can all get together,” said Carla Menominee, Board of Directors of Indian Summer Festival.

There are 569 Native American tribes, all of them different and unique in their own way. Most of these tribes have different languages, traditions and cultural habits, but the one thing that unites them is their desire to preserve their cultural values through the sacredness of the Pow Wow. The 19^th Annual Winter Pow Wow took place in Wisconsin State Fair Park, WI on March 6^th and was organized by Indian Summer Festival Incorporated.

Father and son from the Cree tribe enter the circle to take part of the 19th Annual Winter Pow Wow in Wisconsin.

Usually a Pow Wow is set up in a circle with the drummers in the middle. The event begins with the so called ceremony Grand Entry, in which all dancers enter the circle led by representatives of different tribes carrying their flags and a Native American veteran who carries the American Flag. After that the Pow Wow is officially open and all people start dancing in the circle moving clockwise.

Nearly every Native American tribe had its own distinctive style of dress, and the people could often tell each other's tribal identities by looking at their clothes, headdresses, and ornamentation.

“The Pow Wow is very important for us because it is the place where we come together and share our culture and traditions,” said Carla Menominee, Board of Directors of  Indian Summer. “That is why our missions as an organization are to educate the public about Indian American culture and also to make sure that we have a venue for our  community to come together.”

Mary Greendeer, 88 who now lives in the Reservation of the Oneida tribe in Wisconsin has dedicated her life to the preservation of her culture. Back in the early 1950’s she lived in Chicago and has fought for the establishment of The American Indian Center in Chicago. Her husband Frederik Greendeer from the Ho-Chunk tribe has also been an active member of the community and was personally honored by President Richard Nixon. Today she thinks that the Pow Wow is even more important for her community, “Our children live in big cities and go to non-Indian schools. They don’t pay much attention to what we tell them and soon they forget our traditions,” Mrs. Greendeer said.

Because the The Bald Eagle and the Golden Eagle are extinct specimens, possession of their feathers on the territory of the US is illegal. Indian American people are the only community that has the legal right to possess these feathers, in order to practice their rituals and traditions.

David Gutierrez, 50 is originally from Mexico. Even though he is not Native American he is inspired by the culture and is regularly taking part in Pow Wows. “When I moved to Wisconsin, I was fascinated from the work of Wisconsin Dance Studios and that is how I started practicing Native American tribal dancing,” Gutierrez said.

“The eagle is a sacred bird in our culture,” said Lolly Aguibir, 40 from the Ojibwe tribe in Texas, New Mexico. “We believe that the eagle is the bird that can fly the highest, and when we pray, it takes our prayers up in the sky.” That is why Mrs. Aguibir and her husband set up a family business which produce feather holders that protect feathers from harming.

Women from the Wisconsin Pink Shawl Initiative took part of the Pow Wow. “The Wisconsin Pink Shawl Initiative is established to raise awareness and educate the American Indian community and people worldwide about breast cancer,” said Anna Padron a representative of the organization.

Mary Greendeer,88 , from the Oneida tribe with her husband’s head dress. “ I think that the basic value Indian American people have is their dedication to their families and the community”, Mrs. Greendeer said.

Vanny Wheelock, 44 from Greenbay, WI watches dancers from different tribes perform with her grand daughter, Osa Florse, 2. “For me, Pow Wow is an opportunity to get together with my family and friends so we can practice our traditions and pass them to the next generation,” Wheelock said.

Another significant member of the community, Irene Bedard, who was the voice behind the Disney character Pocahontas is concerned about the languages of her community. “I think that there is a lot of work that needs to be done in order to keep our culture alive, but definitely the number one priority should be our languages, which are mostly spoken in the reservations,” Bedard said. Carla Menominee is concerned about language preservation too, “Only for the State of Wisconsin we have eleven federally recognized tribes and each tribe has its own language,” she explained.

Talissa Prude, 4 from the Menominee tribe lives in Milwaukee, WI with her family. Her mother started teaching her the language of her tribe when she was two years old. “ I want her to grow up knowing our language and traditions, so she can know her roots,” her mother, Mrs. Prude said.

William Boulware is a professor in Federal Indian Law at Chicago-Kent Law School and Executive Director of Native Land Development Company which is a commercial real estate development firm specializing in Native American Land development. He has also worked as an attorney for the Oneida and Ho-Chunk tribes.

Contemplating about the future of the Indian American culture he finds a correlation in the history of the United States. “My impression of the Indian American people is a reflection of the history of this country and their ability to be self sufficient, “ Boulware said.  “If you look at the history of the United States, it is a country that basically pursued genocide. Sometimes deliberately, sometimes accidental because there was an attempt for Indian American’s population to be assimilated from what was colonial America.”

Now he thinks that Native American tribes are diligently focused on their future, “I think that tribal governments are trying to re-establish themselves and are working in the direction to re-assert their sovereignty.”

What is interesting is that, there are certain federal laws from a legal standpoint that view tribes differently from other communities. Tribes themselves are an individual government. “There is racial classification known as Native Americans but when it comes to dealing with the law they are a political entity, not a racial entity, “ William Boulware explained.  “The genesis of the political nature comes from the fact that there are all these treaties signed by the US government with the individual tribes, or a collective groups of tribes, that give the right of tribes to reserve certain things for themselves.”

Because the Native American community in the US is a minority, there are some special laws concerning the practice of their culture. For example, only Indian Americans have the right to possess an eagle feather. Because the eagle is an extinct specimen, possession of its feathers is illegal. In their culture the eagle is a sacred bird. It is believed that this is the bird that can fly the highest and when Native American people pray, the eagle takes their prayers up in the sky.

To listen to an interview with William Boulware, professor of Federal Indian Law at Chicago-Kent Law School, about the relationship between Native American tribes and the US government, click here.

To watch a video from the Pow Wow, click here.

]]> http://posttheworld.wordpress.com/2010/03/16/smoke-signals/feed/ 0 posttheworld 1 3 7 8 6 4 2 10 9 5 http://posttheworld.wordpress.com/2010/03/09/made-in-china/ http://posttheworld.wordpress.com/2010/03/09/made-in-china/#comments Tue, 09 Mar 2010 04:36:06 +0000 posttheworld http://posttheworld.wordpress.com/?p=21 ]]> Chinese designer Ping Wu talks about her post-”Project Runway” career

“I had always been inventive and very good at hand crafts. But back then, "designer" was an unknown term in China. Thank God, now I know! Otherwise, it'll be a terrible pity in my life.”

Photo courtesy : Barbara Nitke for Lifetime TV Network

Ping Wu has combined the professions of a physical therapist and fashion designer all her life. Originally from Chengdu, Sichuan Province, China, Wu received an education in Fashion Design from Instituto Marangoni in Milan. She is known for her numerous professional accomplishments as a designer and her participation in the last season of the reality show “Project Runway.”

In 2007, Wu participated in Beijing’s International Fashion week, Premierre Classe Trade Show in Paris and was one of the five accessory artists featured for the 40th anniversary of the Chicago Museum of Contemporary Art. During the same year, she also launched her own fashion brand. Now she is focused on developing her new winter line and promoting Ping Wu Design Studio.

I got a chance to sit down with Wu, who now lives in Chicago, and ask her about her life as a fashion designer.

MK: When was the first time you realized that you want to be a designer?

Ping Wu: In 2003, after I experimented with ceramics, making hand-made greeting cards, knitting, and making garments … All of a sudden, I realized that I really had something special in me, and I’m most interested in designing. In fact, in my childhood, I had always been inventive and very good at hand crafts. But back then, “designer” was an unknown term in China. So, I just simply didn’t know there’s such a profession that could utilize what’s naturally in me! Looking back, I feel like it took too long to discover this field. Thank God, now I know! Otherwise, it’ll be a terrible pity in my life.

MK: What defines your style of design?

PW: Functionality, comfort, and originality. My signature as a designer is transformable fashion accessories, and all of my garments have some hidden surprises.

MK: What did you learn about yourself from your journey in “Project Runway”?

PW: I surprised myself with how strong I was when it comes down to human values and principles. I really shocked myself that I actually could handle my own hurt and anger so well, despite of being in extremely difficult circumstances.

Designer Ping Wu stands on the runway with her model Elizaveta Melnitchenko in the first challenge, when Nina Garcia and fashion designer Michael Kors absolutely loved her design.

MK: How did you end up in Chicago?

PW: I first moved to Chicago in January 2004, for the following reasons. First, I needed to make more money to pay for my tuition and living cost in Milan later that year. Second, I’m a big city girl. I really missed the big city life by then. Third, I would like to be in a cosmopolitan place that’s not too far from my friends in Champaign-Urbana. And fourth, I wanted to be a contracting therapist for the maximum freedom in choosing where and when I want to work.

MK: What is your idea and goal with Ping Wu Design Studio?

PW: I would like to create a modern American brand producing a native Chinese designer, me. Basically, I design products and then try to sell them on international market. The idea is to give myself maximum freedom to create and design but at the same time, the market reality should be my only judge.

MK: What inspires you?

PW: Daily problems in average people’s lives. I’m very curious and interested in people, life, cultures, religions, and world in general. I constantly observe, question, and think … We all exist in this world shortly so we should be useful and helpful for each other and for the society, we all should contribute in our own ways. I’m constantly searching for my way.

MK: What do you think is the most important thing, that designers and other artists who are self-employed, should know?

Ping Wu's losing design.

PW: The most valuable things in life are invisible. Never choose this path only because you have no other options, or if you think it’s going to be an easier life, or for making more money … The only most powerful tool that’s going to help you through a journey like this is your absolute passion and persevere character towards the subject.

MK: What is your ultimate goal as a designer?

PW: To be free, to be happy, to be Ping, forever and ever. To bring more Pingish products to my inspiring customers who are just as daring, creative and independent!

One of the most popular examples of a news aggregation Web site is Newser. Its main purpose is to be a news source that relies on stories from other media outlets. The cornerstone is that Newser takes the story from another media and redesigns it and makes it shorter. It is no wonder that the sites slogan proclaims “Read less, know more”.

Why is Newser more convenient than traditional media?

First, by selecting the most important news and repackaging the content in a more digestible format, Newser.com saves people from having to browse multiple sites looking for a specific story. Second, by summarizing the stories into two paragraphs, people do not need to spend time reading a 5,000-word story in order to get the news. And third, it is interactive and allows you to be an active participant in discussing the news.

Why is Newser the future of media?

Because of all the different communication channels that the Internet provides and its enormous dimensions, the readership audience is no longer loyal to only one news outlet. The time when people held a newspaper in their hands and used it as the only source of information is definitely a thing of the past. Web sites like Google news and Breaking tweets provide everything a person needs to know about today’s news. There are also Web based outlets like Chicago’s windy citizen, which will serve the best if you are looking for local news.

As the founder of Newser, Michael Wolff says, “It is clear that there is a new business that is replacing the old business.”

Information provided by Chicago Police Department Records.

FLYPmedia is the perfect example of how the characteristics of previous media forms should be compiled into one. It is a completely Web based digital magazine that uses great photographs, impressive graphic design, embedded videos and audio combined to tell stories. By using all these tools in telling the stories, FLYPmedia gives its readers the impression of all the perspectives that can exist on a single topic.

FLYPmedia is powerful! If you read and article in the newspaper about a new music artist, you will not be able to really get idea of what this artist is like. On the contrary, if you have a look on a story developed in a Flyp- like way, you will understand everything you need because  you probably will not only read facts about this artist, but you will also be able to watch him rehearsing and recording.

There are already companies like Zinio and Zmags that have centered their businesses on creating and developing digital magazines. Since its founding in 2006, zmags has worked with 2500 companies in 50 countries. That fact shows that digital publishing and Web based storytelling is one of the main directions new media will take. The difference is that the products of Zinio are just digital magazines and you have to pay for them while FLYPmedia is free and is all about the multimedia platform.

Here you can read an interview with Jim Gaines, former Time Inc corporate editor, and editor-in-chief of FLYPmedia.

With the increase of online news outlets over the years, journalists have been forced to work harder in conveying their work and personal image. A web blog is already considered the minimum that a journalist could do to market themselves. Using social media sites like Facebook.com and twitter.com as a means to promote their work will soon be just a little more than the minimum.

In order to get closer to their audience, journalists need to create their own distinguishable image through their work. This can be accomplished if they manage to construct their own personal space (a blog) and design it so that it represents their unique voice. The new journalist is not stuck to the rules of one media, but is himself a media outlet. A media outlet that cannot afford to censor himself and should not avoid being personal to his readers. Although, a true journalist should never blur the line between making a comment and reporting the news.

Moreover, a successful journalist needs to be a multi-skilled storyteller. One that can use different tools and software to not only provide content, but also allow their audience to visualize the story through the use of imagery, video and audio.

In the end, the basic values of the old school journalism (reporting, being bias free, investigating, and verification) are the core of the profession that will not be changed. Thomas Griffith has said that “Journalism is in fact history on the run.” The typewriter has been replaced by the computer, and now we can see that little by little the computer screen is replacing the TV screen. The flow of information and the communication channels have and will continue to change, but journalism will still be history on the run. That is why the new journalists of today have to be highly adaptive and eager to always develop their professional skills set, because we never know when the next big change will happen.